Full TT 6 Months Ago And Still Have A Pooch. Is This My Final Result?

Sometimes there can be a little residual fat below the belly button after tummy tuck. Sometimes it is just not safe to be too aggressive with getting it out at the time of the surgery or else risk a healing problem. It shouldn't be a big deal to have it improved with a little lipo. Most surgeons would not charge for a small touch-up like that though you will probably have to pay a small facility fee. Discuss calmly with your surgeon. I'm sure he/she would want to make you happy.

This is hard to say without a picture.  In general, six months after surgery most results (whatever the outcome) are stable.  Revisit with your PS to see if this was the best possible outcome based your pre surgical anatomy.

Dr. ES

Without an exam only general comments can be made. The lower abdomen is the last place for final swelling to subside after a tummy tuck and can take longer than 6 months. Persistant fluid (seroma) collection is possible and may be investigated with an ultrasound if clinically indicated. Skin that was tight immediately after the surgery may stretch more than expected after surgery and lead to some laxity. The fat layer may be too thick because your surgeon elected not to reduce this to give you the best chance of avoiding a severe complication. Lastly, significant weight loss or gain after surgery will also compromise the tone and shape of your lower abdomen.

As you can see, there are several issues that can be affecting your final result. Your PS can help you to understand what the issues are and discuss possible solutions. If more surgery is considered then you should expect to pay the costs of revisional surgery. Sometimes the PS may offer to not charge their full fees, but your results to date do not entitle you to have more surgery for free.  Both parties need to be reasonable when some disappointment occurs and this underlies the importance of understanding the financial policies prior to having a procedure performed. Stay positive and explore your options.

Dr. Mosher

Without photographs and more information it is impossible to tell why you continue to have fullness in your tummy.  The only way to know what happened and if this is "normal" is to talk to your plastic surgeon and look at your before and after pictures with them.  Although in most patients the lower tummy with flatten with tummy tuck, it is abnormal looking if it becomes "too" flat.  Also, there are several post operative complications that could lead to fullness in this area, such as a seroma, which is a collection of fluid.  I would want to have my plastic surgeon examine me and have a frank discussion about this issue.

 Thank you for the question.

As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.

Generally, the abdominal wall "pooch" after tummy tuck may be related to:

1. Swelling in the soft tissues.  This may take several months to resolve and may worsen with increased activity  or at the end of the day.   Patience  is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.

2. Fluid accumulation in the space between the skin and the abdominal wall muscle.  this may consist of blood ( hematoma)  or serum (seroma).  This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound  may be helpful).  Treatment consists of aspiration;  several episodes of aspiration may be necessary.  

3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination  with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.

4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year  (or greater)  a complete skin redraping  to occur.

I hope this helps.